4.

Application of Bioceramics in Orthopedic Implants Natural bone has self-

repair capability after the damage. The smaller fractures heal itself correctly,
however segmental bone defects (SBOs) lead to permanent paralysis
[109,110]. SBOs fractures treated with autologous bone graft technique
requires harvesting of non-vital bone, such as, the iliac crest. However, some
complexities are also associated with bone grafting such as bone availability,
the mismatch between harvested bone and affected site, morbidity of donor
site results in poor integration [111]. Over the past three decades, a variety of
synthetic materials have been introduced to overcome the complexities such
as calcium phosphates (bioactive glasses) and hybrid bioceramics-polymer
materials [112- 115]. Table 5 showing different materials for bone tissue
engineering.
Table(Zafar et al., 2019)

Bioceramics are considered often as the inclusion of both amorphous and

crystalline inorganic biomaterials. They are typically categorized as
synthesized inorganic materials having crystalline structure, which are often
called “bioceramics” without any other specification, and synthesized
inorganic amorphous materials that are referred to as bioactive glasses.
Bioceramics have significantly been used for the repair or replacement of
damaged hard tissues for more than 50 years due to their excellent
biocompatibility, osteoconductivity/osteoinductivity, and close compositional
and mineralogical similarity to the inorganic component of the bone (Hench,
2006; Lin et al., 2014; Kaur et al., 2019; Zhou et al., 2019).

Ceramics have the added challenge of being highly brittle, poor handleability
of green (pre-sintered) parts, making complex shape high strength parts
challenging to manufacture.

Calcium phosphate cylindrical scaffolds are standard in the litera-

ture, as outlined by ASTM standards F2883–11 and C1424–15. Previous
methods to create scaffolds include solid and porous cylindrical con- structs
using HA and calcium sulfate with binder jet-based 3D Printing [5]. Another
study focused on creating porous cylindrical scaffolds with inner architecture
to make the depowderizing process easier post 3D Printing [6]. A unique
flexible 3D printer created cylindrical scaffolds made of HA [7]. While these
scaffolds were innovative in the printing process, they do not show complex
external features to the base cylin- ders [9–11]. Additionally, a scaffold
with complex external surfaces and unique topography will
increase the basic scaffold’s outer macro-level surface area. The
surface area plays a vital role in cellular attachment, as it provides
anchoring areas that cells can expand and extend [12,13]

Our work investigates the addition of different protruded bulk surface fea-
tures instead of porosities to increase the surface area to volume ratio of
scaffolds to enhance biological fixation without compromising the me-
chanical strength. Bone defects can be complicated with non-uniform sizes
and bring about the need for intricate topography. There is a cur- rent lack in
the literature that addresses the feasibility of creating bio- ceramic scaffolds
with unique macro-level architectures that can address site-specificity for
individual patient treatment. It is vital to understand how these external
features will affect mechanical properties and s
ta- bility, (Vu et al., 2021) .

Vu, A. A., Burke, D. A., Bandyopadhyay, A., & Bose, S. (2021). Effects of
Surface Area and Topography on Mechanical Properties of 3D Printed
Tricalcium Phosphate Scaffolds for Osteoblast Proliferation in Bone
Grafting Applications. Additive Manufacturing, 39(December 2020),
101870. https://doi.org/10.1016/j.addma.2021.101870
Zafar, M. J., Zhu, D., & Zhang, Z. (2019). 3D Printing of Bioceramics for
Bone Tissue Engineering. Materials, 12(20), 3361.
https://doi.org/10.3390/ma12203361